History of Telemedicine

 Since its inception, the field of telemedicine has evolved dramatically. A few hospitals began experimenting with telemedicine to reach patients in remote areas just about fifty years ago. Telemedicine has developed into a complex integrated service used in hospitals, homes, private physician offices, and other healthcare facilities as a result of rapid technological advances over the last few decades.

Telecommunications technology, the means of transmitting information over a long distance in the form of electromagnetic signals, gave birth to the idea of telemedicine. The telegraph, radio, and telephone were among the first examples of telecommunications technology. The radio and telephone were just beginning to appear as viable communication devices in the late nineteenth century. The telephone was patented by Alexander Graham Bell in 1876, and Heinrich Rudolf Hertz made the first radio transmission in 1887.

However, it wasn't until the early twentieth century that the general public became aware of these inventions and realized that they could be applied to medicine. Dr. Hugo Gernsback's strange creation, the "teledactyl," was featured on the cover of Science and Invention magazine in 1925. The envisioned tool would examine a patient from afar using spindly robot fingers and radio technology, and show the doctor a video feed of the patient. Though this innovation never progressed beyond the concept level, it foreshadowed the modern meaning of telemedicine: a remote video consultation between a doctor and a patient.

A few hospital systems and university-based medical centers experimented with how to bring the idea of telemedicine into operation many decades later, in the 1950s. Medical workers from two different health centers in Pennsylvania, separated by about 24 miles, exchanged radiologic images over the internet. A Canadian doctor created a Teleradiology system in the 1950s, which was used in and around Montreal. Then, in 1959, doctors at the University of Nebraska were able to use a two-way interactive television to relay neurological tests to medical students around campus. They developed a telemedicine connection in 1964 that enabled them to provide health services at Norfolk State Hospital, which was 112 miles away from campus.

This technology was originally created by health practitioners to reach out to remote patients in rural areas. However, as time went by, medical professionals and the US government saw the big picture – the opportunity to reach urban communities with healthcare shortages and respond quickly to medical crises by exchanging medical consults and patient health records. The US government, including the Public Health Service, NASA, the Department of Defense, and the Health and Human Sciences Department, made major investments in telemedicine research and development in the 1960s. Around this time, the tradition of sending heart rhythms during emergencies began. For example, in Miami, the university medical center collaborated with the fire department by transmitting electro-cardiac rhythm signals from the rescue sites over voice radio channels.

The Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC), a collaboration between NASA and the Indian Health Services, was one of the most active government-funded telemedicine projects. The program assisted Native Americans on the Papago Reservation in Arizona, as well as astronauts in space, by offering remote medical services. Projects like STARPAHC fuelled medical engineering research and assisted in the development of telemedicine. Continuing advances in telemedicine and broader study at hospitals, medical facilities, and research companies marked the next several decades.

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